What is the role of visual evoked potential (VEP) testing in the workup of migraine?

Updated: Oct 25, 2019
  • Author: Andrew B Evans, MD; Chief Editor: Selim R Benbadis, MD  more...
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Shibata et al recorded pattern-reversal VEP to transient checkerboard stimulus in 19 patients with migraine with visual aura (ie, classic migraine), 14 patients with migraine without aura (ie, common migraine) in the interictal period, and 43 healthy subjects. [22] Latencies and amplitudes of pattern-reversal VEPs in each group were analyzed.

P100 amplitude was significantly higher in patients with classic migraine than in healthy subjects, whereas latencies of pattern-reversal VEPs did not differ significantly. [22] No significant differences were noted in latency between the common migraine group and healthy subjects or in latencies and amplitudes of pattern-reversal VEP between the classic migraine and common migraine groups.

Zgorzalewicz found prolongation of P100 and N145 latencies and reduction in amplitude in migraine patients in 1 hemisphere. [23]

These results suggest that patients with classic migraine may have hyperexcitability in the visual pathway during interictal periods and that the increased amplitude of pattern-reversal VEPs after attacks may be due to cortical spreading depression.

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